Drug users with and at-risk for HIV continue to have poor access to health care and poor treatment outcomes. In addition, opioid addiction involving prescription opioids has skyrocketed. In this proposal for a mid-career investigator award, Dr. Chinazo Cunningham proposes to address the opioid epidemic and it's intersection with HIV infection by: 1) becoming an internationally recognized leader in the field of drug abuse and HIV, expanding her research to include comparative effectiveness research (CER) methods; 2) developing a standardized and structured mentorship approach to mentor junior investigators to conduct patient-oriented research related to drug abuse and/or HIV infection; and 3) becoming an effective leader in academic medicine, ensuring that the institutional infrastructure facilitate junior investigators obtaining skills necessary to become independent investigators. To achieve these goals, Dr. Cunningham will participate in courses and national conferences, have directed readings, and regularly meet with national leaders in related fields. Dr. Cunningham will particularly focus on mentoring women and racial/ethnic minorities-two groups who are under-represented in senior positions in academic medicine and NIH-funded research. Dr. Cunningham will utilize her existing research program as a foundation for which she will provide mentoring and expand her research skills to include CER methodologies. The aims of her research are to: 1) test the efficacy of a 16- week abstinence-reinforcing contingency management intervention on HIV viral load suppression among opioid-dependent HIV-infected individuals, using a randomized controlled trial design; and 2) examine mechanisms of achieving viral load suppression with the abstinence-reinforcing contingency management intervention. Dr. Cunningham's future research will include the establishment of a comprehensive live database of all opioid users within a large urban medical center. This database will be used to examine health outcomes associated with types of opioid use and to develop and test interventions focused on opioid use. Dr. Cunningham's long-term career objective is to improve access to care and health outcomes among drug- abusing populations with or at-risk for HIV infection by developing interventions that can reduce their disparities in health care and health.